Leadless Pacemaker
A pacemaker is a small device that treats a slow heart beat.
Your doctor has recommended you undergo the implantation of a Leadless pacemaker.
You might not have heard this medical term before now and may be feeling unsure about the nature of the procedure.
This information sheet will outline what the procedure involves, what preparations are required and what risks are involved.
After you read this information sheet, you might still have questions. If you do, please contact the team at Heart HQ. We’re here to help.
What’s a Leadless pacemaker?
A leadless pacemaker is a small self-contained battery powered device that is inserted in the right ventricle of the heart to treat a slow heart beat.
There are two different types of leadless pacemakers. Your doctor will advise which one best suits your condition.
• Leadless AV — pacing in the ventricle (lower chamber) and sensing in the atrium (upper chamber)
• Leadless VR — pacing in the ventricle (lower chamber)
Everyone’s heart is different, so your pacemaker will be ‘programmed’ by your doctor specifically for your needs. Once it’s been installed, it will be checked by a technician using an external machine and the rate of the pacemaker can be set. Tests will be done where the pacing speed will be temporarily increased and decreased. Then a ‘normal’ pacing speed will be set.
Your pacemaker is designed to ‘stand by’ until your heart rate falls below the set rate determined by your doctor. If this occurs the device will step in and ‘pace’ your heart rate to the set level.
How does it work?
An intravenous line (IV) will be placed into a vein in your arm. This is for the medical team to administer medication throughout your procedure. You may be given antibiotics to prevent infections. A sedative will also be given.
You will have an injection of local anaesthetic below your collarbone. Using a small incision, your doctor will thread the pacemaker lead/s into a vein and down to your heart.
During the procedure, your doctor will be able to see see the lead/s using x-ray imaging. Once the lead/s are positioned correctly, we will test them to make sure they are working properly.
The leads will then be connected to the ‘pulse generator’, which will be placed under the skin before the skin is sewn back together.
What do I need to do to prepare?
You will need to fast for six hours before the procedure.
What happens after the procedure?
The procedure is performed in hospital with an overnight stay.
Please note you will not be able to drive a vehicle for two weeks after having a pacemaker installed. Please limit your arm movement on the side of the pacemaker for the first two weeks to allows the pacemaker levels to settle.
We will check the device system in your device clinic appointments.
It is important that after your pacemaker has been implanted, you remember to tell your other treating medical teams in the future, especially if an MRI has been ordered.
What kind of risks are associated with this procedure?
Any kind of procedure carries some element of risk, often very small and rare.
Your doctor has balanced the benefits and risks of carrying out the test against the benefits and risks of not proceeding. If your doctor has recommended this procedure, they believe there is benefit to you going ahead.
It’s important you understand the risks involved so you can make an informed decision.
Here are the most commonly reported risks and complications associated with a pacemaker installation.
Common risks and complications (More than 5% of cases)
- Minor bruising at the puncture site
- Major bruising or swelling at the groin puncture site
- Bleeding from the puncture site
Rare risks and complications (less than 1% of cases)
- A hole is accidentally made in the heart valve—this may require surgery or drainage to repair
- Blood clot in the lung
- Device migration requiring retrieval
- Surgical repair of the groin puncture site of blood vessel
- Minor reaction to the x-ray dye such as hives
- An allergic reaction to the x-ray dye
- Kidney injury due to side effects of the x-ray dye
- A stroke—this can cause long-term disability
- Death is possible due to the procedure or other heart problems
Leadless pacemaker info sheet